Risk and association of HLA with oxcarbazepine-induced cutaneous adverse reactions in Asians
| Autor: | Chun-Bing, Chen, Yi-Hsin, Hsiao, Tony, Wu, Mo-Song, Hsih, Wichittra, Tassaneeyakul, Teekayu P, Jorns, Chonlaphat, Sukasem, Chien-Ning, Hsu, Shih-Chi, Su, Wan-Chun, Chang, Rosaline Chung-Yee, Hui, Chia-Yu, Chu, Yi-Ju, Chen, Ching-Ying, Wu, Chao-Kai, Hsu, Tsu-Man, Chiu, Pei-Lun, Sun, Hua-En, Lee, Chin-Yi, Yang, Pei-Han, Kao, Chih-Hsun, Yang, Hsin-Chun, Ho, Jing-Yi, Lin, Ya-Ching, Chang, Ming-Jing, Chen, Chun-Wei, Lu, Chau Yee, Ng, Kang-Ling, Kuo, Chien-Yio, Lin, Ching-Sheng, Yang, Ding-Ping, Chen, Pi-Yueh, Chang, Tsu-Lan, Wu, Yu-Jr, Lin, Yi-Ching, Weng, Tseng-Tong, Kuo, Shuen-Iu, Hung, Wen-Hung, Chung |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Male National Health Programs 0302 clinical medicine Gene Frequency Prospective Studies Prospective cohort study Child Aged 80 and over education.field_of_study Incidence (epidemiology) Incidence Middle Aged Thailand Carbamazepine Child Preschool Anticonvulsants Female Adult medicine.medical_specialty Adolescent Genotype Population Taiwan Oxcarbazepine Statistics Nonparametric 03 medical and health sciences Young Adult Asian People Meta-Analysis as Topic Internal medicine medicine Humans Genetic Predisposition to Disease education Aged Retrospective Studies Epilepsy HLA-A Antigens business.industry Retrospective cohort study Odds ratio medicine.disease Confidence interval Toxic epidermal necrolysis 030104 developmental biology HLA-B Antigens Relative risk Stevens-Johnson Syndrome Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Neurology. 88(1) |
| ISSN: | 1526-632X |
| Popis: | Objective:To investigate the risk and genetic association of oxcarbazepine-induced cutaneous adverse reactions (OXC-cADRs), including Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), in Asian populations (Chinese and Thai).Methods:We prospectively enrolled patients with OXC-cADRs in Taiwan and Thailand from 2006 to 2014, and analyzed the clinical course, latent period, drug dosage, organ involvement, complications, and mortality. We also investigated the carrier rate ofHLA-B*15:02andHLA-A*31:01of patients with OXC-cADRs and compared to OXC-tolerant controls. The incidence of OXC-SJS/TEN was compared with carbamazepine (CBZ)–induced SJS/TEN according to the nationwide population dataset from the Taiwan National Health Insurance Research Database.Results:We enrolled 50 patients with OXC-cADRs, including 20 OXC-SJS/TEN and 6 drug reaction with eosinophilia and systemic symptoms, of Chinese patients from Taiwan and Thai patients from Thailand. OXC-cADRs presented with less clinical severity including limited skin detachment (all ≦5%) and no mortality. There was a significant association betweenHLA-B*15:02and OXC-SJS (p= 1.87 × 10−10; odds ratio 27.90; 95% confidence interval [CI] 7.84–99.23) in Chinese and this significant association was also observed in Thai patients. The positive and negative predictive values ofHLA-B*15:02for OXC-SJS/TEN were 0.73% and 99.97%, respectively.HLA-A*31:01was not associated with OXC-cADRs. The incidence and mortality of OXC-SJS/TEN was lower than CBZ-STS/TEN in new users (p= 0.003; relative risk 0.212; 95% CI 0.077–0.584).Conclusions:Our findings suggest thatHLA-B*15:02is significantly associated with OXC-SJS in Asian populations (Chinese and Thai). However, the severity and incidence of OXC-SJS/TEN are less than that of CBZ-SJS/TEN. The need for preemptiveHLA-B*15:02screening should be evaluated further. |
| Databáze: | OpenAIRE |
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